NUVARING
FACT SHEET/CONSENT

The NuvaRing is a flexible contraceptive vaginal ring. It combines progestin and estrogen, two kinds of female hormones, to prevent pregnancy. It is 98% to 99% effective when used properly. Using the NuvaRing does not protect you from sexually transmitted infections. If you or your partner have other sexual partners, you should use latex condoms to help prevent infections, even though you are using the NuvaRing.

HOW TO USE THE NUVARING

To achieve maximum contraceptive effectiveness, the NuvaRing must be used as directed. One NuvaRing is inserted in the vagina and must remain in place continuously for three weeks. It is removed for a one-week break during which menses usually occurs. A new ring is inserted one week after the last ring was removed.

The user can choose the insertion position that is most comfortable, for example, standing with one leg up, squatting or lying down. After washing your hands, the ring should be compressed and inserted into the vagina. The exact position of the NuvaRing inside the vagina is not critical for its function. The ring should be inserted on the appropriate day and left inside the vagina for three consecutive weeks. This means that the ring is removed three weeks later on the same day of the week as it was inserted and at about the same time. Nuva Ring can be removed by hooking the index finger under the forward rim or by grasping the rim between the index and middle finger and pulling it out. After a one-week break, during which menses usually occurs, a new ring is inserted on the same day of the week as it was inserted in the previous cycle, regardless of whether or not you are still bleeding.

WHEN TO START THE NUVARING

Counting the first day of your period as "Day 1", NuvaRing should be inserted on or before Day 5, even if you have not finished bleeding. Use condoms and/or spermacide as your back-up method for the first 7 days of your first NuvaRing.

DEVIATIONS FROM RECOMMENDED USAGE

Inadvertent removal, expulsion or prolonged ring-free interval - If NuvaRing has been out of the vagina during the three-week use period, it can be rinsed with cool to lukewarm water and should be reinserted as soon as possible, at the latest within three hours. If the ring has been out of the vagina for longer than three hours, contraceptive effectiveness may be reduced and an additional method of contraception should be used until NuvaRing has been used continuously for seven days. If the ring-free interval has been extended beyond one week, the possibility of pregnancy must be eliminated. After pregnancy is ruled out, an additional method of contraception should be used until the NuvaRing has been used continuously for seven days.

STORAGE

You may store your NuvaRing at room temperature for up to 4 months. If you refrigerate your NuvaRing, you may use it until the expiration date shown on the box.

You should not use the NuvaRing if you have had, now have or develop…

Blood clots in the veins or arteries Cerebral vascular or coronary artery disease

Valvular heart disease Severe hypertension

Diabetes Headaches with focal neurological symptoms

Major surgery with prolonged immobilization Cancer of breast, liver or reproductive organs

Undiagnosed abnormal genital bleeding Known or suspected pregnancy

Allergic reaction to components of NuvaRing

Talk to your health care provider about using NuvaRing if…

You smoke cigarettes, especially if your are older than 35 years of age
You are breastfeeding
You have gall bladder disease
You are using other medications, such as antibiotics, anticonvulsants or drugs to treat HIV/AIDS. These drugs can make the NuvaRing less effective in preventing pregnancy
You have a family history of breast cancer.

Possible side effects of NuvaRing include vaginal infection and irritation, vaginal discharge, headache, weight gain or loss, nausea and/or vomiting, changes in appetite, abdominal cramps and bloating, breast tenderness or enlargement, irregular vaginal bleeding or spotting, temporary infertility after discontinuing the NuvaRing, fluid retention, spotty darkening of the skin, particularly on the face, rash, depression, intolerance to contact lenses.

CALL US AT ONCE IF YOU EXPERIENCE ANY OF THE FOLLOWING SYMPTOMS

Crushing chest pain	Vision problems
Unusual swelling/pain in legs or arms	Unusually heavy vaginal bleeding
Yellowing of skin or eyes	Absence of menstrual period
Shortness of breath	Sudden onset of severe headaches
Severe depression	Severe abdominal pain
New breast lump

I have read this fact sheet and request that NuvaRing be prescribed for me.

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